Tuesday, August 31, 2010

Can I have your Attention for just a moment please?

OK, Listen up folks.
 I want ALL of you EMS types to repeat after me, and I mean ALL of Y'all. If you are a First Aider, CFR, MFR, EMT, AEMT, EMT-I, D, B, A, Paramedic, WEMT, WCFR, or any other variation. If you respond to medical calls in any manner and touch patients, I really want you to take this oath:
Repeat after me:

(I can't HEAR YOU!)





A FLASHLIGHT (or Penlight)




OK, 'Nuf sed?

Monday, August 30, 2010

Eureeka! I have figured it out!

Before I was in Fire and EMS I was a normal person with normal thought patterns and responses. During that period I was always curious about why the wait was always so long in most Doctors Offices when you had made an APPOINTMENT days, weeks, or months in advance. They knew you were coming. There was no surprise. They had LOTS of time to prepare for your arrival. What was the problem here?
 Now when I was a child, everybody in my family saw the same GP. Good old Dr. Hennighan. The Doc was old school and didn't even have a receptionist. He did it all himself. All he used was a service to schedule his appointments. We never waited more than 15 minutes past our appointment to see him unless he had an emergency. In this case his daughter (the Doc's house was next door to his practice), would come over and announce to the waiting room that "Daddy just called from the Hospital and says he is very sorry, but he has an emergency. He will be about an hour. If you want to leave and reschedule, that would be fine. If you don't mind waiting he will see you when he gets back. Mommy is making some coffee and cookies to bring over in a few minutes. My Daddy is very sorry to have put you all out."  Everybody understood, and either stayed or didn't. It was the way things went. Of course I have fond memories of this Doctor walking into my bedroom when I was sick to check on me. He would write prescriptions, but then drop them off at the pharmacy on his way to the next call. The pharmacy would deliver the prescriptions within two hours, no extra charge, unless the Doc asked them to rush it, then we might see it in 30 minutes.
 Yes, this is true, it was the way things were when I was a kid, really. (Important to note: I am NOT as old as you think, I am still interior certified.) No not every Doctor was like that, but MINE was. He passed away when I was in my twenties and I cried when I heard the news. He was truly a good, compassionate, and excellent man. The last time he treated me ( I was around 20) was for a spontaneous pneumothorax. My Surgeon told me that there wasn't 1 GP in 500 that would have picked that out on an x-ray and I should count myself lucky. I did, all the time.

 Today, things are a bit different. I am spending a CONSIDERABLE amount of time in Physicians offices as we tend to the last years of my 2 aging parents. GP, Cardiologist, OB/GYN, Wound Care Center, Urologist, and a couple of others. WE average an appointment a week. I take care of the home care medical needs and when I am traveling I have a blessed fellow EMT on my Squad that covers for me with my folks.
This past Monday I spent 2 1/2 hours in an Office so my Dad could get 5 minutes of Physician Contact time and 10 minutes of skilled nursing time. We waited 45 minutes to get in (first appointment of the day, so HOW can they be 'behind'?), and they had him on the table in an uncomfortable position for another 45 minutes, and eventually he felt the call of nature. This patient is 91 years old. The nurse says, "we should be done in just 15 minutes". I said "I don't think he can wait that long, it's been a long time already and he is in a lot of pain. Getting up and then back on the table again is going to be very difficult on him." I wanted to say "I t SHOULD have taken 15 minutes and HOUR AGO". But I didn't. My Pop started to get up, but then the Doctor came in and made fairly quick work of the exam and told the Nurse to bandage him up. She began to collect the things she would need to do the bandaging job. I'm thinking 'was this a surprise to her?' Then she leaves the room to get some more 'stuff'. Pop is really uncomfortable now and I know this won't end well if we don't kick it up a notch. I put on a pair of gloves and started prepping the wound site and cleaning it up. (This whole thing is more of a procedure than just slapping a bandaid on, I've been trained by this very office to do this and I do it at home for him all the time). The nurse returns and look in horror that I have gloves on and am working on HER patient. I just said "he can't wait much longer, lets do this". She looked at what I had done (mouth still hanging open) and says "Hey that's pretty neat work, you've done this before." "Yup", I grunted and we finished it up in about 2 minutes. We got him to the bathroom just in time.
 On Friday we spent 2 1/2 hours at Mom's Cardiologist for 8 minutes of Physician contact time and 5 minutes of Nursing time. This was for a bi-annual checkup with nothing new to report, no blood tests, no med changes. Most of the time was spent trying to remind the Doctor of my Mom's issues.
 Someday soon my employer is going to start complaining about the time I am taking from work for all these appointments.

 So I mentioned before that I am a manufacturing professional. In MY field we are constantly re-evaluating how to do things better, faster, and with higher quality. Time is money. We are routinely re-tooling to improve our work. So it drives me crazy to sit in a Doctor's office with plenty of people running around and NOBODY concerned about moving patients through. Yes, obviously, I get that patients need to get the time they need. But the 'value added time' here is actual patient treatment, counseling, and support. Everything else is waste and should be eliminated from the process. Wasted time, wasted movement, no value added.

 So at the top I said I finally figured it out. Here is the answer. Are you ready?

They don't care.

 Just like sloppy Medics, Sloppy EMT's, sloppy E/D's, they just stopped caring. They forgot what their mission is.  They don't see good patient flow as part of a quality operation. They don't think it matters and they think everyone should just accept it. After all, where would they be if they weren't here? Sitting at home watching TV? They can do that here, we have cable. I'm inclined to think they should get rid of the cable and get on with doing their job in a satisfying manner.

Well, at least now I know why.

Sunday, August 29, 2010

"I don't think you've ever seen this before.."

The previous post (Lord, I apologize..) made me think about some of the jobs I have worked while at the paying job over the years and I thought I'd share one with you. There was the one where a co-worker opened up his arm from the shoulder to the pinky tip down to the bone is a spiral cut that circled his arm once. But I thought that wasn't really a good one, and then I remembered this one which happened many years ago:

I met the rig in the parking lot of the shop. I had gone outside for three reasons: 1) We had the patient in as good a shape as we good expect and there was nothing more to be done at the moment, 2) I felt that the previous person I had sent out to meet the ambulance and guide the crew in was not doing his job because they weren't on scene yet, and when I realized why... 3) to call dispatch one the phone and talk them through giving the responding crew directions to find us. I could hear their siren going up and down streets a half mile away on a road with a similar, but different name. I followed the sound through every wrong turn and re-direction. It was comical, even in light of the serious issues my co-worker was coming to terms with just a few feet away in the shop.
 So I greeted them in the parking lot and reached to grab a bag and give them a hand. I said to the Medic, "before you go in. let me explain that you have probably never seen anything like this and there are special treatment procedures involved, I have printed out detailed ...." She just walked past me saying "yeah, everybody says that, but I've seen it all. Where is he?" OK, I think, guess we'll just have to see what she wants to do with this one and I followed her into the building giving directions from behind. As she approached the patient seated calmly in a chair with a crowd of slack jawed people around him she started to say "SO, Whats going on gu.... WHAT HAPPENED HERE?! HOW did this happen?! WHAT is that?" She was looking at a male patient in his early thirties and good physical condition except that his right arm was more than twice it's normal size, and his hand was nearly three times normal. It appeared that his arm had been inflated, which it actually had. In truth, it looked like a plastic gag arm because the skin was so taught it was shiny (it was also wet which added to the plastic effect). "It's his hand" I said calmly, now relishing the fact that I had the attention of this mighty Paramedic that has 'seen it all'. She looked at me and said "I have NEVER seen anything like this!" I cleared my throat and suppressed a smile, "Well, it's an injection wound. We have that machine over there  that cuts anything from steel to glass using water. It pushes the water out of a tiny orifice at 55,000 PSI and carries an abrasive medium along the outside of the water column. It can pop a hole through 1/4" stainless steel in 750 milliseconds. Matt here was distracted for a moment and let his hand get under the jet. The force of the water filled his hand and forearm in the 2 seconds it took to pull his arm out. There is no exit wound, all the fluid went into his arm. As far as we can tell, the jet did not cut any bone, but you'll need x-rays to confirm, as this thing cuts bone like paper. Now I have a medical treatment document from the machine manufacturer here that has detailed clinical treatment procedures. They have a lot of experience with these wounds. There is also an 800 number the physician can call for consultation. The biggest threat with these wounds is infection and sepsis. Urgency is needed to minimize the spread. His arm has, in effect, just been pumped full of bacteria. Any other questions I can answer?"
"Just one" she politely said, "Can I have that 800 number?"

Saturday, August 28, 2010

He's BACK!

No other way to say it: MARK is back. On his terms and in his time, we can look forward to the first class work we got so used to reading, and have missed so dearly.
 The dude is back. Spread the word.
 There is justice, and today, life is good indeed.

Friday, August 27, 2010

This above all: To thine own ass be true (or just "CYA")

Warning: Mild rant ensues.

To recap what I am for my newer readers ( I think I am up to 4 now): by day I work as a professional technical person and evenings and weekends I volunteer as a Firefighter and an EMT. I am a pro-board certified Fire Instructor and teach in my 'free time' from fall to spring and also for my Department where I also serve as an Officer. At my paying job I also serve as the company EMT although this is not part of my job description, I just do it and provide advice on pre-plans, do some training (CPR, AED, Bloodbourne, etc.) and many other odds and ends that escape me at the moment. I have worked in this techncal field for nearly 40 years now and like to think I have gained some experience in the types of accidents and injuries that occur in our workplace. Yes, I have seen some bizarre and ugly stuff. Machinery can do a real number on the human anatomy in short order. Lets just say that I have an idea of what to expect along with the normal medical stuff.
 My current employer is a worldwide company that has 'standards' for everything and especially Health and Safety.. To be honest, they go way overboard on a lot of stuff, but on the whole I see it as a good thing compared to many (most) companies I have worked for that really didn't want to spend more than $20.00 on a first aid kit and no time or money for training. At this job they bought me a trauma bag and filled it with what I requested (all BLS stuff for the first 10 minutes of the job, that's all I need). But they drew a BIG RED LINE when I asked for an O2 bottle and some NRB's. They cited everything from pressurized containers being dangerous, needing a prescription, and how it was a flammable gas. I explianed that the corporate policy clearly states that 'If a facility has personnel with advanced medical training (MFR, EMT, RN, or MD) then the facility should provide equipment and supplies suitable for their level of training". "It's policy", I said. 'Nothing doing', they said, 'Too much liability'. I asked the company what they were going to say in court when somebody's spouse sued the company because their loved one died at work and we didn't have what we needed to do what we had to do. I got a blank look and was refereed to Corporate Headquarters, they referred me to the corporate industrial hygienist, who dutifully repeated that it wasn't going to happen. "You could do something wrong and we could be sued". I rolled my eyes (she couldn't see it from 5 states away) and I resisted the urge to say "yeah, are right patients suffering MI's, angina, and asthma are dropping every day because some fool gives them Oxygen".
 So I asked her "why is it that these industrial first aid company's are advertising in all the safety magazines that the FDA has approved portable Oxygen to be sold without a prescription if it is capable of delivering at least 6 LPM and will last at least 15 minutes. You just order it, and it comes, complete with a nifty wall cabinet to hang next to your AED. She said she wouldn't know about that and anyway, it does not apply in our state. I said "you really SHOULD know about that and find out if it applies in our state as well as the other 49 we have facilities in.
 I explained that my risk assessment of the population revealed a highest potential is for diabetic emergencies and cardiac emergencies, followed by asthmatic problems. I have had 3 in the last 6 months. (See this post and the ones that followed it.) I was trying to have the proper tools to mitigate the highest risk. She advised me to continue my current practice of keeping an O2 tank in my POV and using it as needed, that way it's my ass and not the company's. I told her I wasn't too concerned about my ass, I was thinking of my patients ass, or more accurately their well being.
I chatted with the nurse a little more and found out she had E/D experience. I asked if she had ever worked 'out in the field' and she said "oh yeah, once I had to care for a patient on an international flight with absolutely nothing to work with. Worst 5 hours of my life". I empathized, "Yeah it's tough. Those of us in EMS do that everyday, but we have our tools, and we get pretty good at working in tough situations, that is, when somebody isn't keeping us away from our tools." I paused, then added "just like you are doing now." Bureaucrats.

Saturday, August 21, 2010

I am Spent

.Sometimes I think I am too emotional for this sort of work.
 Last week I spent about 20 hours working on my research and PowerPoint presentations for this year's round of OSHA refresher classes. There is a team of us who teach, and these last 3 years I have been asked to come up with a new section to keep the class fresh. Some of the stuff we need to cover every year, but each year we do 2 or 3 completely new sections. Obviously the material has to fall into the subject matter OSHA wants to see, but the topics are broad and leaves a lot of lattitude. This year, under the subject of 'scene safety' I decided to do a call review of a very recently released NIOSH report about an incident that resulted in an LODD.
 Although any LODD is unacceptable and not really something I want to discuss in a classroom setting, this one grabbed me because I have the technical knowledge required to really understand what occurred. I was traveling when the incident occurred and I received an email from a fellow instructor about the possible cause. He had his opinion, I had mine, they were different, but it turned out I had it right. None the less, I followed the story all the way through.
 Writing a lesson plan based on a tragedy is a fine line to walk. There is no intent to find fault at the original incident scene, the intent is to teach the lessons learned from that incident and prevent it from happening again. I always assume that those on scene did the best they could with the knowledge and tools they had. My job is to increase that knowledge for the next responders to handle a similar incident. I think I did a fair job on this one, but we'll see what the other instructors say when they tear it apart at our meeting next week. That's how we make things better. At any rate, as it stands, the presentation and notes are done pending tweaks and revisions.
 But some time in the middle of the night I had a brain fart. I am always trying to get my students to 'appreciate' the seriousness and degree of difficulty involved in these type calls. I want to make sure they 'get it' and internalize it, so that when the time comes, they can pull it back out. In other words I am looking for them to PAY ATTENTION. I try to make it so that they have no choice and WANT to suck up this information. This particular subject, being as complicated as it is, is hard to get across, at least in the first few minutes. So I had this idea to run a series of videos during the break just before my session. It would be up on the big screen while they were getting coffee or stretching their legs. I would use all the news videos that were out there surrounding this incident, starting with the late night news bulletin that first announced the blast with almost no real details. I collected everything I could find and put it in chronological order form the early bulletin through the details, the investigation, the funeral arrangements, the memorials, the fund raisers, the news blips and interviews with those dealing with the aftermath, and all the stuff in between. I bolied it down to about 10 clips. I put them togehter in a timed PowerPoint and just finished reviewing them over and over for about 6 hours to get them in the right order and get the timing correct.

 I am emotionally exhausted. I have looked at the pain on the faces of those closest to the victim over and over during this exercise and it got harder and harder on each run through. I have been close to a small Department that lost a key member on the job and I know what that pain is. It's very real and personal, and watching these videos and interviews took their toll on me just as it took a toll on that entire community. As much as I do not want to share this with my students, I feel I am obligated to so that I remind them what the impact is when something like this happens to any Department. I'll put it together and see what my fellow instructors think. They are a pretty smart group of guys.

But I think for now, I thinking I'm just gonna have a few beers and watch the one eyed monster. I'm not much use to anyone just now.


Friday, August 20, 2010

Free Advice

Lizzie over at Portrait of a Lady is hosting this months addition of The Handover Blog Carnival and her Subject is comprised of questions I have heard many times and have been compellled to answer even when they haven't been asked. So for me, this is a good subject.
 Lizzie is about to enter an EMT program and she asks:

If you happened to be my preceptor during practicum, what would you teach me?

What's the most important thing (or things) that you think I need to know before you sign me off to work on my own?

 To all the newbies I offer this gentle advice:

 80% of life is showing up.

 This means you should be present in all your classes and labs, not just in body, but also in mind and spirit. Learning does not take place if you are not completely involved and actively attending to what is going on. BE in the moment during your classes. This sets the stage for the field work and your career. We are always learning in the field and I don't care how long you have been doing this. You never know when you will see something new, but even on the 'same old' calls, you are LEARNING about the patient in front of you, PAY ATTENTION. (Incidently, as soon as you start calling calls 'routine' you stop paying attention and can miss a critical piece of information. Don't get sloppy.) Be ready to go in your classes and be ready to go when you are working.

The other 20% of life is attitude.

 If you have a can do/can learn/can perform attitude you will succeed in anything you attempt. We all start out this way because we believe we can do the things we want to do. The key is that when you learn that what you wanted is not as easy as first thought, and there is some work and difficult moments involved, your desire begins to wane. You must recognize this and work through it. If you want it, you have to really want it, and that means working through the problems and dealing with the distasteful parts. Some things (and these are usually hard to predict) will trip you up. You need to work through these. You need to probe your weaknesses when they show up and find out how YOU can deal with them. If you master these things and keep a positive attitude about yourself, you have what you need.

 The rest is gravy and all the other advice falls in the tid-bit category. It's all about wrapping your mind around the job and 'coming to play and win' everyday. You will lose a fair amount of the time, but that should not prevent you from playing the game. Also, realize that just about EVERYBODY in this business has something that really shakes them up. Some folks can't handle eye injuries, some (many) have troubles with PED calls, I have seen a lot of these. I know one Certified Public Safety Diver who cannot walk out on a frozen pond. He will not do Ice Jobs, but he'll search for bodies in black water all day long. I have a great deal of trouble dealing with animal rescues. I have no freakin' idea why, but do not attempt to talk to me after we pull a dog out of a river. Leave me the hell alone, I am doing my paperwork and headed home right after the shift. NO, I do NOT want to 'talk about it'. When/If you find your 'thing', you need to find a way to work through it. You signed up for this work and you cannot show up at one of these jobs and say "sorry, I don't DO those". You need to deal with it and get it done.

 Lastly, remember to breath occasionally. Take it all in and think about what you did, AFTER the call. Always look to do a better job next time. Treat every patient as if they were your neighbor, parent, or friend. Respect your co-workers as well as your patients.

 You'll do fine. Oh, and don't forget to keep your head down and the exit in sight at all times.

Thursday, August 19, 2010


Every once in a while we (ok, I) need to stop and clean some things up. As I am generally a slob, I should probably do it more often, but I am a very busy guy.
 In this sense, I am taking a little time to say thanks for some of the blessings that have come my way in recent weeks and months. I am not always one to remember to thank folks for the nice things they do for me, I just hope to return the favor when the opportunity arises.
 Bolstered by the possible good news from Medic 999 (yes, I continue to think positive thoughts Mark), my good fortune to re-establish contact with a wonderful relative-in-law I lost contact with (last time we talked he was working in the North Sea, and China, as I recall, now he is some where in the Sahara Desert) and am looking forward to catching up. He has a wicked commute, because he lives in none of those areas, but that's another story.
 So it's time to say thanks for my blessings.
 I'd like to thank those who write the way I would like to and bring useful information and stories to the Emergency Response community every day of the week.
 There is a reason that Firegeezer is my homepage and the first thing I read everyday. The gents over there were kind enough to print some of my words before I had an outlet of my own and continue to be a class act doing work that I could never find the time or the skill for.
 Rescuing Providence is a blog I have read for several years and admired Micheal's writing of each and every piece. He is deft, defined, and a natural. If I could ask him one question (and I have no doubt that I will shake his hand one day and ask him), it would be 'how many re-writes do you do before you put a piece on the blog?'.  I just noticed yesterday that Micheal added a link to MY blog on HIS site. That blew me away that he would even consider reading any of the drivel I write, let alone come back. Micheal has a gift I could not buy with all the tea in China.
 I am blessed that our call volume has been WAY down for reasons we don't understand. This comes at a a time when other parts of my life are causing me as much stress as I can bear, so it balances out. (They say that God doesn't give us any more than we can handle and I am starting to believe that.)
 I am blessed that we have some young and enthusiastic members that are coming into their own in my (EMS) Company and stepping up to handle the load. It is my privilege and pleasure to share it with them and let them run while I lead from behind. I know they will make good Officers when their time comes in just a few years. I just hope someone steps up at the end of this year to take my job so I can re-charge and move on to new challenges.
 As always, I am thankful for Justin and Mark who got my blood flowing and made me look into this blogging thing and think it was something I might try.

I still don't produce the kind of content I would like to, that would require quitting one of my jobs. I would like to share the things with my readers that I share with the people who attend my Fire classes, or I teach down at our own department. Fortunately we have lots of people out there that do an outstanding job and I still can't figure how they find the time, but I'm glad they do. Check out some of the links in the right sidebar on this page.

So that's a few of the things I am thankful for. How about you?

Wednesday, August 18, 2010


Just got home from the paying job and while shoving down dinner, I checked once again on THIS SITE in the hope that today might be the day it was revived.
 So you might want to go to Medic 999's blog and see the little tid-bit he left for all of us.
 Gotta run back out to catch at least one set at my kid's gig tonight. I need a recharge after today and this is just the ticket.
 Not to mention of course how happy I am with the news from Mark!

Tuesday, August 17, 2010

Knowledge IS Power

It's a simple statement: "Knowledge is power". I like it a lot and it has been one of my favorites for many years. To me, it means the more you know, the more you can do. It means the more you know, the safer you can be. It means the more you know, the more valuable you are. It means a lot of things and it rings true for me in so many ways. It's one of the reasons I kept my job last year when so many others were losing theirs. I knew more, and I could do more than a lot of folks in my position. I'm not bragging here, I've spent my whole career learning about everything I come into contact with. Not just say " Hey, that's neat" and move on. I always stop and ask questions about this 'new thing'. I ask how it works, what is does, ask to try it, try to figure out how I can use it, either now, or sometime down the road.
 I have also worked in many 'adjacent' jobs to mine at several different levels from hands on, up to project design and management.
 Most people have knowledge that gives them power. This is particularly true if you work in a specialty field such as Fire, EMS, Law Enforcement, etc. This knowledge does not come cheap, but those of us who have it tend to take it for granted. That is to say that we don't appreciate what we have between our ears. For us, its 'common knowledge'.
 At my paying job (NOT in Emergency Services) I do some teaching from time to time. Subjects include the occasional technical training for newer employees as well as industrial safety issues that I am suited for. My employer is a Global Company and has lots of rules and mandatory training. We are running some type of training just about every month. Sometimes we combine subjects and knock off several in a single session. These are the annual refresher classes that EVERYBODY has heard year after year. Very exciting stuff. I teach one or two of these also. The other person who runs many of these sessions (I stop clearly short of calling him an instructor) uses the same PowerPoint presentation EVERY year which he downloaded from the Corporate training site without any proofreading, customizing, or personalizing. He presents it in a manner that makes it clear he has no interest in what he is shoveling out, and the captive audience clearly gets his message and goes to sleep, only waking occasionally to check their watches. He knows he has to do this every year, and THEY have to listen to it and sign the log before they can leave. It is verbal regurgitation at it's finest. Understandably EVERYBODY HATES THIS. Both the trainer and the trainees.
  I have a different approach. I get asked to teach things I am actually qualified to teach such as Fire Extinguisher training, fire safety, safety at home, Bloodborne Pathogens, CPR, First Aid, and things of this sort. I enjoy teaching, and more importantly, I enjoy giving someone else tools that may help them in a very difficult moment. Consequently I take it seriously. This means I prepare my own lessons, do my own research, teach correct, complete, and accepted practices. I also keep in mind that I must overcome the corporate training attitude, which means I have to work extra hard to keep people interested and present the material in a way that makes them realize on their own that 'this stuff has value!'. I include some useful short videos in my PowerPoint , have hands on things so they can see, try, or practice what I am teaching, and I try to use humor and take time for a laugh or two. My three rules are: the material has to be fresh, any videos I use MUST be something they have never seen before, and I never give the same presentation twice, even if it's a year later. I update each presentation every time I give it. New videos, new verbiage, updated data.. Amazingly, it all works. I explain WHY this stuff is important, not only at work, but at home, not only for the Company, but for their Family. I teach how they can apply what I teach to improve their own lives or careers. I make it personal, I GIVE them something they can use: I give them power to make a difference. My knowledge becomes their power. By giving them what I have, I get much in return. I am no genius, I just know something they don't and am willing to share it.
 If you think making a great stop on a fire is a rush, or bringing back a patient from an overdose, try teaching somebody something and having them come back later and tell you how it made a difference in their lives. 

"Give a man a fish and he will eat for a day, TEACH a man to fish and he will eat for a lifetime."

 We all have knowledge which has power and value. If you feel stagnant or are just looking for new outlets, try sharing some of that knowledge. You don't have to be a Paramedic Supervisor or Senior Fire Officer with years of experience. You might be a relatively new firefighter, a CFR, First Aider, EMT, or what ever. But there are people who can use some of your knowledge to improve their lives. Think about Church groups, Scout groups, senior citizen centers, Junior Firefighter programs, or possibly at your own paying job. These people can learn a lot from you, and you can learn a lot from them, especially about yourself. If your not so hot on the presentation stuff, do some checking around. Find something on the net, it's there for the taking. Just check the facts, customize it for your needs, and let it rip. You don't need computers, projectors, sound systems or any of that stuff. The internet is overburdened with lesson plans. There are lots of materials on government sites like OSHA, NIOSH, NIST, and those type places. Check around, ask some more experienced instructors.
 Almost every time I do a class I get at least several people that come up and thank me, ask follow up questions, and tell me about things they really enjoyed in the presentation. This tells me that not only did I get the message through, but they actually enjoyed our time together. Sometimes I get some really nice compliments about the difference I made for someone. I have yet to hear my co-worker/psuedo-instructor get a single compliment beyond "Thanks for keeping it really short". I know it is beginning to bother him a bit because he is starting to make an effort to understand the material and teach it better. Maybe someday I'll teach him how.

Knowledge is power, go out and give someone else the power.

Sunday, August 15, 2010

Go figger…

This is definitely the last vacation post on it won’t go up until we are home, unpacked, and slept in for a few hours. On Friday we went down to the local EMS Agency (see last post “What was I thinking”). So when the wife dropped me off and at the very last second my son (a Firefighter) says “do you mind if I tag along?” “Well no, but it might be boring for you.” “I’ll be fine” he says.
The irony was not lost on me. A few years ago when we were up here and I said that I was going into town to visit the local Squad and introduce myself, my son said “why would you want to do that?” I explained that you never know what you might learn from another Agency about things they do better than us, or differently. I might make some new friends, or find something good that we could take home and use. He thought I was either bored or crazy, but he knew his Dad does ‘this stuff’ from time to time and it’s best to just let him do it. Now, 3 years on, I have his curiosity up and he wants to see what’s going on ‘in there’ to keep me coming back for visits.
So in we go and as it turns out my buddy has had his appointment schedule re-arranged for him by a late arriving new member and Wally asks if we would mind waiting while he takes care of business. “No Sweat” we said, “Take your time”. So we spent a little over an hour relaxing at the station and having nice conversations with the crews as the shift change occurred. I took some pictures of the neat new feature on the rig they just got in. I’m making notes for the new rig we will be spec’ing out soon. I asked the crews a lot f questions about what they like and don’t like on the new box. We passed the time with some very nice conversations with some extremely friendly and hospitable folks. I always enjoy these visits.
Wally finishes u and returns. We chat about stuff since the last time we met, what conferences he will or won’t be doing in the coming year. He tries to talk me into doing Baltimore next year and bringing my wife so the wives can have fun together while Wally and I do our thing.
Then he turns to my son and asks “are you a Firefighter?” “Yes” my son says. Wally probes as he half looks at me “So what are you doing tonight? You look a little like the young red-neck buck type that might enjoy some stock car races. Or would you rather hang out with your Mom & Dad?” My son has little idea where this is going, he only just met Wally, and he comes up with a cautious reply; “Yeah I go to the dirt track from time to time, but I enjoy truck pulls more. It’s all good though”. Wally Smiles, “I have a crew doing a standby at the races tonight and we’ll set you up and get you in with the crew. You just have to hang with them. They usually have a good time, and a few weeks ago Tony Stewart showed up to race. So you never know, are you interested?” My son accepts the invitation with thanks. Wally goes off to find him an agency shirt and ID Tag and also inform the crew they had a new member. I bring him back to the cabin for a quick shower, some food, and better shoes and pants. As it turns out, my EMS pants fit him just fine. Then we run him back into town just in time as the crew is ready to depart. He got home after midnight and is sleeping now, they only had one patient but another crew did the transport and they swapped rigs to stay on post. So he also got a ride home in their new rig.
So I guess it was more than luck that I threw my uniform in with my packing on this trip. I didn’t get the ride time, but my son did while I came back to the cabin and started packing up for the trip home. He’s out having fun and I’m cleaning the boat out and missing the last night of fishing. It was worth it though. He had a good time and maybe he learned something too. About making friends in new places and stepping forward to introduce yourself when you don’t have to. You never know where it might lead.
P.S. This is the sunset hew missed, but perhaps he didn't really miss it..

Saturday, August 14, 2010

What was I thinking?

Last vacation post, I promise (unless something interesting happens).
In the weeks preceding our vacation trip I was pretty busy and didn’t have much time to prepare, either my fishing gear, or myself. But I did mange to drop and email off to the Director of the local EMS agency here in vacationland and tell (ok, warn) him that we would be returning this week and I would like to stop by for a visit and/or chat. Last year he and I spent a pleasant half a day riding around in the fly car doing the agency chores and he showed me some of his bigger exposures while asking for my opinion on pre-plans and mitigation possibilities. I very much enjoyed the day, as well as the morning having breakfast with his crews. I’d like to think he got something out if it also, and certainly he was successful in recruiting me to attend an EMS conference in the fall where he was presenting and wanted some ‘friendly’s’ in the audience. (The presentation went well and he was gracious in including me on his discussion panel as ‘someone with good ideas that should be shared’.)
This year, in my pre-arrival email I asked what he thought about me grabbing a little ride time with one of his crews. I thought the experience in a different geography, hospital system, and EMS region might be helpful to me. He dropped me back a quick terse note stating that I was welcome to ride with them anytime I wanted, just show up..
What was I thinking? I am ON VACATION! More importantly, my wife and son are ON VACATION. The last thing they want is for me to say the same thing to them during this singular week of rest is “Hey, I gotta go”. Which is family speak for “I am on duty and I have to run this job.” I do this all the time at home. I think it would be a bad idea to start doing it here and now. It’s bad enough that I spent about 15 hours this week working on my lesson plans and research for the fall training sessions.
I know I was thinking that there would be a rainy day where bad weather would keep us off the water and nothing but reading a book would seem appealing. I thought that would be a good ‘ride day’. But we didn’t get that this week and my better half indicated that she expected me to ‘be around’ and ‘do some STUFF’ together (code words for ‘shopping’).
Going off to spend a day riding an ambulance or sitting in a station seems like a poor idea right now. The week is nearly done, the sun is still out, and I am out of time to fit this in. If I am lucky, I can run into town and see my buddy for a quick visit. I think he’ll understand.
Sometimes I come up with the stupidest ideas.

Friday, August 13, 2010

Lines In the Sands of Time

After the realization that drove the previous post, remembering what happened just a year ago, I started to think about other things that happened during this week in years past. We’ve used this same week, give or take a calendar shift, for our family vacation for so many years that I can’t remember how long it’s been.
The second week in August serves as a marker in my yearly calendar. Summertime activities and schedules work around “is it before vacation?”, “is it after vacation?”, or “will it interfere with vacation?”. Consequently, this week serves as a marker for me, a line in the sand if you will.
For Instance: Six years ago, on this very day, my son and I along with a group of close friends were in the middle of a 60 mile backpacking trip through the Sangre de Cristo Mountains in New Mexico. It was the trip of a lifetime. I do remember that we had to cut our vacation up here short so that we could drive home, shower, check our packs, and head out the next morning to catch a train to a bus, to a plane, to a van, to another bus, so we could begin our trip. One day I was fishing in the Great Northeast, and 36 hours later I was standing on top of a 12,000 foot mountain.
Seven years ago, we cut our vacation short again because of a family medical emergency back home. We packed in haste and drove directly to the hospital.
Five years ago, my daughter could not join us for the trip north because she was leaving in the middle of the week for a trip to Australia.
Last year, within an hour of our arrival home I learned about Jack and spent the next 2 days making a flurry of phone calls and spending an hour or two on the phone providing a shoulder for somebody who needed it. 2009 will always stay in my mind as the year I attended 3 LODD services for people or agencies I had a connection with. I hope never to do that again.
And so it goes, all markers in the sand. As I get older I rely on these markers to help me remember things and place them in their proper places in the timeline that is my life. Some are important, some just fond memories, some not so pleasant, but pieces of what I am just the same. At some point I know the tide will come up and wash the sand smooth again. It seems like it is working it’s way up now, very slowly, but it is coming up.
Today is our last full day for our visit up here this year and I am wondering what markers I have collected this year. This time tomorrow we will be packing the van to get on the road and back to home and the daily hassles it brings. I know I will hear all about the 2 major calls I missed, on Monday my boss will tell me about all the things I should have had done before I left, and there will be meetings to catch up on.
I’ll let that sit for another day or so. We still have today in front of us and its time to go fishing. All we have to do is pick a good spot.


Wednesday, August 11, 2010

For Jack… forgive me, I almost forgot

In the Fire and EMS services we are fond of saying ‘Never Forget’. This is a reminder for those of us who have felt the loss of a comrade to keep them in your thoughts, remember the lessons they taught us either directly or through their actions, and to honor both their memories and the sacrifice they made. May God forgive me, I almost forgot Jack.
This blog, as many Fire Blogs, has the National Fallen Firefighters widget placed in the side bar. Each day around midday, a new Fallen Firefighter is listed in the widget with links to his or her story. This all leads up to the culmination of the ceremonies at the National Fallen Firefighters Memorial. I like the widget because it helps me remind others of those who will fight the beast no more as well as reminds us to always be vigilant, lest we succumb to the monster.
On August 9 and 10th, Jack Horton’s picture and story showed up in the widget. Ironic that it showed up this week and where I sit now. It was just a year and a couple of days ago that I returned home from the standard family vacation and after unloading the van I went to my PC to catch up on all the reading I had missed in the previous week. I was looking at the usual pages and came across the story of Jack’s Line of Duty Death report on Firefighterclosecalls.com. At first I missed it, but then the name of the Department stuck in my head, followed by the state, and I had the realization in that split second that something terrible had happened to people I hold dear. I got on the phone right away and started calling family members in the town to find out how those so close to me were holding up under the strain. It took agonizing hours before I got a call back from the Department giving me he basic details and information on what I could do to provide support.
Because I maintain this blog in an anonymous manner, I cannot divulge my connection to Jack’s Department or its members, besides, it really doesn’t matter. Let’s just say “I’m related” and leave it at that. My main concern was to support the members of Jack’s department in anyway I could. I did not know Jack, but I learned an awful lot about him during the weekend of the Memorial Service and since. Jack was a wonderful Dad, a fantastic Chief , and indispensible as an Assistant Chief. Jack was the ‘safety nut’, always drilling into the younger members the safest way to do things and to “NEVER cut corners”. Jack was also the Department Instructor and focused on working safely and efficiently. Every member I know or met in his Department had a special respect for Jack because of the encouragement he offered each member at their own level based on their particular needs. In a Department having around 20 active members, Jack’s loss represented a tremendous blow to this dedicated and close knit team. Jack was Chief for many years before turning the post over to a ‘younger officer’.
It is in no small way ironic that Jack lost his life at a ‘routine’ auto accident call. The patient was waiting for EMS so he could sign an RMA, and the Department was assisting with traffic and the wrecker pulling the vehicle back onto the road. Jack suffered a fatal heart attack while acting as the backer for the engine. The rest of the details are not important. What remains is the pain of Jack’s loss to that small Department and his family, neighbors, and friends.
It becomes the responsibility of all of us to remember Jack, as well as all of those brothers and sisters who have made the ultimate sacrifice in service, be they career or volunteer. We need to carry on the lessons they taught us, and the friendship they shared with us. They are indeed, part of what we are today.
Here’s to you Jack.

Tuesday, August 10, 2010

I hope you appreciate this..

Last night I was thinking about Mark Glencourse and all the trouble he had in ‘frisco getting a connection to get his posts online. He would have done something drastic if he were in my shoes now.
We are ‘vacationing’ along the US/Canadian border in a very popular summer destination. Great fishing, fantastic boating, lots to see and do. But in the winter time the population drops by about 85%. Thusly, not much effort goes into broadband access for the masses. After all, anybody can do without their computers for a week or two right? Besides, who would even want to bring a computer with them on vacation anyway?
SO I sit here in our little paradise on the screened in porch of our rented cottage looking out across a 20 mile wide river to Canada.. It truly is beautiful and that’s why we’ve been coming here, to the same cabin boat rental from the same family for over 30 years. But there is no internet access.
I tell myself it is good for me to get away from all that crap for a week, but still I am sitting here and typing away as I listen to the sounds of kids swimming, boats roaring up and down, and those damned jet-skiers wreaking havoc. (I swear if they would just open a season on them for one year, we could cut the population in half, but that’s another rant.)
If you actually see this post (or the previous post on Knowing your address) show up before the 15th, then you will know that I took the laptop into town and cruise the streets looking for a spot where somebody has a WIFI hub with no security on it. It’s amazing how many are out there. Then I park in front of their home or business and download my mail, upload the blog and retrieve all the blogs I read to enjoy later in the day. I also grab a few research pieces for the lesson plans I am working on while on ‘vacation”. Then I return home and we go fishing or make dinner. In the evening I go through all my reading while my wife reads a book. She left her laptop home.
Some folks don’t realize what a blogger will go through to keep his page updated. But I’m sure both of my readers appreciate it.
Certainly you can appreciate this sunset photo. That is my son and I headed out for some evening fishing.


Monday, August 9, 2010

When you call 911, PLEASE know what your address is…. Really.

In my last post I sort of promised to post this one next, even though I had not yet written it. Here I am a week or so later, and in a world far removed from ‘normal life’ and I really don’t feel like writing this one just now. But a promise is a promise.
The Dispatch:
“Respond to 60 Elm St. for a elderly person down, unable to ambulate. The call came in from Life Alarm from the next door neighbor who is seeking help for the patient.”
The Response:
Routine weekend response, a pick up crew on the ambulance, I pull into the station and see they have a full crew so I run on to the call location in my personal vehicle. We arrive at the address to ask which neighbor needs help. The resident assures us she did not make the call and does not even know what a ‘Life Alarm’ is, let alone has one. We check the neighbor’s houses. No soap. We have a 3 person crew on our BLS rig, the two on the ALS crew that backs us up, a State Trooper that showed up to assist, and about 4 firefighters who came in case we needed lifting assistance. I’m counting about 11 responders, and I start breaking the neighborhood up into sections sending them out in pairs. I call dispatch and inform them of the difficulties we are having locating the address. I ask them if they can call back to the company and get us more info that will help us locate the patient. I team up with the Trooper, but he has his own plan and goes to check number 60 ElmWOOD St. about ½ mile away while I handle things here. I check a few houses looking for the signs. Ladders, yard tools laying about, things like that. I check the house next to the original address we went to and find some contractors working on the roof. I ask about the homeowner. “Oh yeah” one of the carpenters says, “He was here just a minute ago, but I don’t know where he went, he should be around.” We search to no success. I check the next house down: 3 cars in the driveway, front door open, I knock, ring the bell, and yell in “FIRE DEPARTMENT, did you call for an ambulance?” No reply. I repeat the exercise. Nada. I walk around the outside of the house. Zip. The Trooper returns reporting ‘no joy’. I tell him about this house and he repeats my exercise, he walks up to the door and tells “STATE POLICE, ANYBODY HOME?” We make entry, he does half the house and I do the other. He keeps shouting “STATE POLICE” and I am shouting “FIRE DEPARTMENT” and we sound like big kids playing “MARCO” – “POLO” as we walk around the house (perhaps you had to be there). We meet in the back den area and have a good idea of the family makeup: Weekenders, 3 teenagers, and 1 maybe 2 parents. Probably out shopping. We hit every house and no teams report anything remarkable. The teams meet back at the start point. Most think it’s time to give it up as an unfounded call. I don’t feel good about this and say so. I know the Trooper is considering it, but isn’t satisfied just yet. Then we get a call from dispatch giving us the exact address of the caller, “ number 5 Elm Street”, which is at the far end of the block. The whole entourage moves all the vehicles down to the end of the road and we start the search again, looking behind all the houses, in the woods, etc. While the Trooper and I knock on the door. No answer and it is locked. The Trooper finds a side window that is unlocked and he gets it open with no damage. He ‘carefully selects’ one of my young Firefighters and pushes him in through the window with search instructions. No soap, the house is secure and clear.
Just then, I hear one of my crew saying “ Hey! Look up the road, there is an old lady coming down the hill with a walker”. Sure enough, here she comes, down the adjacent street and I am thinking this is our ‘victim’. Yet again, I am wrong, and the lady indicates through her huffing and puffing that she called for her friend up at “number 60” as she points back up the hill from where she came. We relocate all the vehicles one last time and head to number 60 BIRCH Lane.
Sure enough, there she is on her living room floor as we enter the house. She looks up at us and asks “What the heck took you guys so long?” “Well Ma’am, we were looking for you at or around number 60 Elm St.” She says “yes, that’s the address we gave them, WHAT took so long?!” “Ma’am, you live at Number 60 Birch Lane.” “Oh yeah”, she says, “I guess I do, no wonder you took so long. Now can you get me up!” “Well sure Ma’am, but first we want to check you out …… “
It pays to at least KNOW your address, even if you don’t put the number out front where we can find it,

Wednesday, August 4, 2010

Simple Shit............................Perhaps not?

If it were simple, everybody would do it, right? Well yeah, if 'everybody' realized how important "it" was.
It never ceases to amaze me how folks are so sloppy about marking their homes without any thought of the need for emergency services. They have pretty signs which look great in the daylight and have lovely flowers draped artistically over them to provide a proper effect. But at 3am, during an ice storm, the colors are invisible in the dark and even if you could see them, the ice has weighed down the tree branches and covered up the house numbers completely. During a snowstorm at 2am it's even impossible to read the numbers on mailboxes because the snow droops down and covers the sides of the boxes. The change ion landscape during these storms makes it impossible to know where you are even on familiar roads. I was driving the first due engine to a structure fire this past winter and could not read a single number on any mailbox. Of course the flames licking up and out of a living room picture window kind of gave me a clue that I found the correct address.
Around my neck of the woods we have some additional problems in that we have a 'weekend' population. These homeowners fall into several categories such as those who live in The City, and come up on some weekends, those who have a second home here and come occasionally, and those who are celebrities and rarely come except for long periods when they are looking for a respite. They all have one thing in common: they don't get mail here. Because of that, they don't have a mailbox or advertise their address. They usually have some identifying mark they can use for wanted guests, and nothing for those of us trying to help them out when a party guest cracks his/her head open and bleeds on the expensive carpet.
Any responder that has 6 months on the job can recite a story about delays caused by trying to find an address. I have more than a few, several dozen in fact, perhaps more if I really thought about it (but you would have to buy the beer, that would be a long night). But here are just two:
Dispatched to an elderly female, fallen, with a history of stroke, cancer, and cardiac issues. The address is 34 Elderberry Road. I know the road and get there in good time, I find number 28 .... 30 ....32.....168 ...36 ...38. WTF? Houses around here are not in straight lines or complete order, just like the roads, none of which are straight and parallel. I am used to seeing missed house numbers on some streets. I search and think that perhaps they gave the wrong number (it happens often). I check one house that looks like a good candidate. No soap. Then I check number "168" and sure enough, I find the patient. We provide what she needs and as I am filling out my paperwork, I ask about the address again. She says "number 34" and I say "Elly, there is a big beautiful cast iron scripted set of numbers over your garage door that says "ONE SIXTY EIGHT", why its that?" Elly tells me that those are the "OLD NUMBERS, before this 911 system came into use and they changed everybody's house number". "Elly", I said, "that was over 20 years ago. you need to get rid of the old numbers or we will always have trouble finding you when you need us." "Oh" she says, "I don't know. If I take them down it will leave a terrible shadow on the garage that will be ugly and you could still read it anyway. Besides, I have the new number on my mailbox." "Elly, your mailbox was broken off and it's laying in the bushes. You really need to get this fixed right away. You may need to call us again and I want to make sure my crews can find you right away." "Well, ok, if you thinks it's best, but that shadow is going to look just plain ugly." Inside, I am screaming, but outwardly I smile, remind her that it is really important and hope that she remembers to get it done.

Dispatched to a middle aged female with severe chest pains. The address is number 24 Pinky Lane. Now I know that all the "Lanes" inn my district are either private roads or began as private road. I have no idea where this road is and the cross streets I'm given are over a mile apart. I find the road pretty easy. It has 8 mailboxes out at the end where it meets the main cross street... bad sign. Sure enough as I climb up this little one lane dirt track I see that there are only numbers on a couple of homes. I find number 20, but as I go further I find number 30. I back down and go to number 20 and knock on the door. Somebody is home and I explain I am looking for 24. She points across the road into the woods. "How do I get there", I ask. She directs me back down the road to a cut that heads up in the right direction. I find the house and leave my emergency lights on so that incoming units will find it easier. As it turns out, the woods and foliage is so thick that everybody misses it and there is a flurry of radio activity that makes us all sound like morons: "Nope you just passed it, back up and take the cut to the right. See my lights? No, that's the wrong cut, that goes down to the pond, take the next one. Don't you see my lights? Bring a monitor in when you finally get here. I'm a bit busy just now." The patient had a full blown MI working and thankfully did not die because we couldn't locate her home.

As important as it is to mark your house well, it is even more important to KNOW what your address is. More on that in the next post.